|
|
Prepublished online as a Blood First Edition Paper on May 24, 2002; DOI 10.1182/blood-2001-12-0159.
Submitted December 4, 2001
Accepted April 29, 2002
URSODEOXYCHOLIC ACID FOR THE PREVENTION OF HEPATIC COMPLICATIONS IN ALLOGENEIC STEM CELL TRANSPLANTATION
Tapani Ruutu*, Britta Eriksson, Kari Remes, Eeva Juvonen, Liisa Volin, Mats Remberger, Terttu Parkkali, Hans Hagglund, and Olle Ringden
* Corresponding author; email: tapani.ruutu{at}hus.fi.
The role of ursodeoxycholic acid (UDCA) in the prevention of hepatic complications after allogeneic stem cell transplantation was studied in a prospective randomized open-label multicenter trial. A total of 242 patients were allocated to receive (n=123) or not to receive (n=119) UDCA in the dose of 12 mg/kg/day orally from the day preceding the conditioning until day 90 post-transplantation. In the UDCA-treated group a statistically significantly smaller proportion of patients developed a serum bilirubin level exceeding 50 µmol/l (18/123 vs. 31/119, P=.04), and similarly a smaller proportion of patients exceeded the ALAT level of 100 U/l. There was no difference in the incidence of veno-occlusive disease of the liver. Compared to the control group, in the UDCA-treated group there was a non-significant trend towards a lower overall incidence of acute graft-versus-host disease (GVHD) and a statistically significantly lower incidence of grade III-IV acute GVHD (5/123 vs. 17/119, P=.01), stage ++ - ++++ liver and intestinal GVHD, and stage +++ - ++++ skin GVHD. There was no difference in the incidence of chronic GVHD or in the relapse rate. Among the patients given UDCA, the survival at one year was statistically significantly better, 71 vs. 55% (P=.02), and the non-relapse mortality lower, 19 vs. 34% (P=.01), than in the control group. There were significantly more deaths in GVHD in the control group. In conclusion, UDCA administration reduced hepatic problems and severe acute GVHD and improved survival. These results suggest a role for UDCA in the prevention of transplant-related complications in allogeneic transplantation.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
D-C Valla
Budd-Chiari syndrome and veno-occlusive disease/sinusoidal obstruction syndrome
Gut,
October 1, 2008;
57(10):
1469 - 1478.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G B McDonald and D Frieze
A problem-oriented approach to liver disease in oncology patients
Gut,
July 1, 2008;
57(7):
987 - 1003.
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Pene, C. Aubron, E. Azoulay, F. Blot, G. Thiery, B. Raynard, B. Schlemmer, G. Nitenberg, A. Buzyn, P. Arnaud, et al.
Outcome of Critically Ill Allogeneic Hematopoietic Stem-Cell Transplantation Recipients: A Reappraisal of Indications for Organ Failure Supports
J. Clin. Oncol.,
February 1, 2006;
24(4):
643 - 649.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G.C. MacQuillan and D. Mutimer
Fulminant liver failure due to severe veno-occlusive disease after haematopoietic cell transplantation: a depressing experience
QJM,
September 1, 2004;
97(9):
581 - 589.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. R. Wingard, W. G. Nichols, and G. B. McDonald
Supportive Care
Hematology,
January 1, 2004;
2004(1):
372 - 389.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. J. Hogan, M. Maris, B. Storer, B. M. Sandmaier, D. G. Maloney, H. G. Schoch, A. E. Woolfrey, H. M. Shulman, R. Storb, and G. B. McDonald
Hepatic injury after nonmyeloablative conditioning followed by allogeneic hematopoietic cell transplantation: a study of 193 patients
Blood,
January 1, 2004;
103(1):
78 - 84.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Wadleigh, P. G. Richardson, D. Zahrieh, S. J. Lee, C. Cutler, V. Ho, E. P. Alyea, J. H. Antin, R. M. Stone, R. J. Soiffer, et al.
Prior gemtuzumab ozogamicin exposure significantly increases the risk of veno-occlusive disease in patients who undergo myeloablative allogeneic stem cell transplantation
Blood,
September 1, 2003;
102(5):
1578 - 1582.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
